Effect of Rough Surface Platforms on the Mucosal Attachment and the Marginal Bone Loss of Implants: A Dog Study

Assessing the Impact of Various Decontamination Instruments on Titanium and Zirconia Dental Implants: An In Vitro Study

This study investigates the impact of various instrumentation techniques on material removal and surface changes in titanium (Ti)- and zirconia (Zr) implant discs. Ti- and Zr discs were subjected to standardized experiments using various instruments including airflow, ultrasound, carbide, and diamond burs. Instrumentation was performed for 60 s with continuous automatic motion. Abrasion and changes in surface roughness were assessed using profilometry, while scanning electron microscopy was used to examine morphological changes and particle size. Carbide burs predominantly caused abrasion on Ti discs, while diamond burs caused more abrasion on Zr discs. The Ti discs were more susceptible to surface changes. However, among the materials tested, machined Zr discs treated with diamond burs produced the largest particle. In certain cases, a statistical significance (p < 0.05) was observed between the groups, while in others, there was no considerable difference among the means (p > 0.05). These results highlighted the statistical significance of our findings. These results found diverse alterations in surface characteristics of Ti- and Zr discs due to different instruments, with carbide and diamond burs causing notable effects. The findings highlight the need for a careful balance between promoting healing and minimizing harm during implantoplasty.

"Metal-bone" scaffold for accelerated peri-implant endosseous healing

Restoring bone defects caused by conditions such as tumors, trauma, or inflammation is a significant clinical challenge. Currently, there is a need for the development of bone tissue engineering scaffolds that meet clinical standards to promote bone regeneration in these defects. In this study, we combined the porous Ti6Al4V scaffold in bone tissue engineering with advanced bone grafting techniques to create a novel "metal-bone" scaffold for enhanced bone regeneration. Utilizing 3D printing technology, we fabricated a porous Ti6Al4V scaffold with an average pore size of 789 ± 22.69 μm. The characterization and biocompatibility of the scaffold were validated through in vitro experiments. Subsequently, the scaffold was implanted into the distal femurs of experimental animals, removed after 3 months, and transformed into a "metal-bone" scaffold. When this "metal-bone" scaffold was re-implanted into bone defects in the animals, the results demonstrated that, in comparison to a plain porous Ti6Al4V scaffold, the scaffold containing bone tissue achieved accelerated early-stage bone regeneration. The experimental group exhibited more bone tissue generation in the early stages at the defect site, resulting in superior bone integration. In conclusion, the "metal-bone" scaffold, containing bone tissue, proves to be an effective bone-promoting scaffold with promising clinical applications.

The influence of immediate intraoperative loading with a splinting component on supporting tissues during a one-stage implant

OBJECTIVE

Aim: To study the specifics of the impact of immediate intraoperative loading with a splinting component on supporting tissues during a one-stage implantation protocol.

PATIENTS AND METHODS

Materials and Methods: In the course of the study, orthopedic treatment was carried out for 55 patients aged 29 to 60 years. The following were performed: cone-beam computed tomography, software planning and intraoral scanning with an optical scanner, one-stage implantation protocol, assessment of implant stability with the Osstell ISQ device, microcirculation study in the peri-implant area using laser Doppler flowmetry (LDF).

RESULTS

Results: It was established that around loaded implants there is an increase in blood flow and vasomotor activity of the microcirculatory channel of the supporting tissues, an increase in the volume of bone tissue and an increase in torque, which is the optimal forecast for the acceleration of the pace of osseointegration.

CONCLUSION

Conclusions: The use of a splinting component during immediate intraoperative functional masticatory load accelerates the dynamics of bone tissue remodeling processes around the implant, which is an optimal prediction of osseointegration rates in various dental implantation protocols and is consistent with high values of the implant stability coefficient.

EVALUATION OF DYNAMIC CHANGES IN THE MICROCIRCULATION OF THE MUCOSA IN THE ZONE OF DENTAL IMPLANTATION WITH IMMEDIATE INTRAOPERATIVE LOAD

OBJECTIVE

The aim: Study of the dynamics of changes in the average values of the index of mucosal microcirculation after dental implantation with immediate intraoperative prosthetics.

PATIENTS AND METHODS

Materials and methods: In clinical conditions, 55 patients aged from 29 to 60 years with a diagnosis of partial absence of teeth requiring orthopedic treatment using implants on the lower jaw were treated and examined. In the course of the latest achievements, the following methods were used: clinical protocol of immediate implantation with Solidum and Simplex implants of the «ART IMPLANT» system on the lower jaw by the one-stage implantation method, with immediate intraoperative loading and the manufacture of a temporary non-removable dental prosthesis, determination of the microcirculation index in dynamics using the laser Doppler method flowmetry, statistical analysis.

RESULTS

Results: The obtained results indicate a pronounced reaction of microcirculation up to the 3rd day after surgery, an increase in blood perfusion of the mucous membrane by 2.7 times while maintaining vasomotor activity, which indicates adaptation to the injury and immediate loading of the denture in the postoperative period. 3 months after dental surgery and immediate intraoperative prosthetics, all indicators of microcirculation approach the initial values before surgery.

CONCLUSION

Conclusions: With the help of laser Doppler flowmetry, the fact of a sharp restoration of microcirculation after dental implantation surgery with immediate intraoperative prosthetics is confirmed.

A Retrospective Study on the Transferring Accuracy of a Fully Guided Digital Template in the Anterior Zone

The accuracy of implant placement with a fully guided digital template can be influenced by many factors, such as arch difference, alveolar bone density, timing of implant placement and open flap. The purpose of this article was to evaluate the factors presumptively affecting the accuracy of implant placement assisted by the fully guided template in the anterior zone. In 40 patients with missing anterior teeth, a total of 52 implants were placed with tooth-borne, fully guided templates after CBCT evaluation, in West China Hospital of Stomatology, Sichuan University. After overlapping the pre-and post-operative DICOM data, measurements were taken in the dental implant planning software (Nobel Clinician^®) to calculate linear and angular deviations between virtual placement plan and actual implant placement. Grouping was categorized according to three factors that possibly have an influence on accuracy: arch type (maxilla/mandible), timing of implant placement (immediate/delayed), surgical technique (open flap/flapless). The data was analyzed with independent sample t-test (p < 0.05). The results showed that the apical, coronal, depth and angular mean deviations of implant positions in anterior zone were 1.13 ± 0.39 mm, 0.86 ± 0.33 mm, 0.41 ± 0.66 mm, 3.32 ± 1.65° with the fully guided templates. The accuracy at apex level, coronal level and the angulation were similar between the maxilla and mandible, and the magnitude of all four deviations between immediate and delayed implantation, open flap and flapless technique were small. No statistically significant difference was observed (p > 0.05). Whereas there was significant difference in depth deviation between maxilla and mandible (p < 0.05). Conclusively, the implant site, alveolar bone density, timing of implant placement and surgical techniques merely compromise the implant placement accuracy under the assistance of a fully guided template.

Assessment of implant surface and instrument insert changes due to instrumentation with different tips for ultrasonic-driven debridement

Background

To assess the changes of implant surfaces of different roughness after instrumentation with ultrasonic-driven scaler tips of different materials.

Methods

Experiments were performed on two moderately rough surfaces (I—Inicell® and II—SLA®), one surface without pre-treatment (III) and one smooth machined surface (IV). Scaler tips made of steel (A), PEEK (B), titanium (C), carbon (D) and resin (E) were used for instrumentation with a standardized pressure of 100 g for ten seconds and under continuous automatic motion. Each combination of scaler tip and implant surface was performed three times on 8 titanium discs. After instrumentation roughness was assessed by profilometry, morphological changes were assessed by scanning electron microscopy, and element distribution on the utmost surface by energy dispersive X-ray spectroscopy.

Results

The surface roughness of discs I and II were significantly reduced by instrumentation with all tips except E. For disc III and IV roughness was enhanced by tip A and C and, only for IV, by tip D. Instrumentation with tips B, D and E left extensive residuals on surface I, II and III. The element analysis of these deposits proved consistent with the elemental composition of the respective tip materials.

Conclusion

All ultrasonic instruments led to microscopic alterations of all types of implants surfaces assessed in the present study. The least change of implant surfaces might result from resin or carbon tips on machined surfaces.

Five Degree Internal Conical Connection and Marginal Bone Stability around Subcrestal Implants: A Retrospective Analysis

BACKGROUND

There is limited information on the effect of the connection between subcrestally placed implants and abutments on marginal bone levels. The aim of the present retrospective study was to evaluate marginal bone levels after definitive prosthesis delivery around implants with an internal 5° conical connection placed in a subcrestal position.

MATERIALS AND METHODS

Patients treated with fixed prostheses supported by implants placed at a subcrestal level between 2012 and 2018 were recalled for a follow-up examination. All implants had 5° internal conical connection with platform switching. Radiographic marginal bone level (MBL) was measured. MBL change between prosthetic delivery (t₀) and follow-up examination (t₁) was calculated. A multiple regression model was performed to identify the most significant predictors on MBL change.

RESULTS

Ninety-three patients and 410 implants, with a mean follow-up of 2.72 ± 1.31 years, were examined. Mean MBL was -1.09 ± 0.65 mm and -1.00 ± 0.37 mm at t₀ and t₁, respectively, with a mean bone remodeling of 0.09 ± 0.68 mm. An implant's vertical position in relation to the bone crest, the year of follow up and the presence of type-2 controlled diabetes were demonstrated to be influencing factors for MBL modifications.

CONCLUSIONS

Subcrestally placed implants with platform switching and internal conical connection maintained stable bone levels over a mean follow-up of more than 2 years. How a tight internal conical connection between abutment and implant may contribute to this clinical evidence should be more deeply investigated. MBL variations seem to be mostly influenced by an implant's vertical position and presence of type-2 controlled diabetes.

Long-Term Clinical Outcomes of Treatment with Dental Implants with Acid Etched Surface

Implant dentistry constitutes a therapeutic modality in the prosthodontic treatment of partially and totally edentulous patients. This study reports a long-term evaluation of treatment by the early loading of acid-etched surface implants. Forty-eight partially and totally edentulous patients were treated with 169 TSA Defcon® acid-etched surface implants for prosthodontic rehabilitation. Implants were loaded after a healing free-loading period of 6–8 weeks in mandible and maxilla, respectively. Implant and prosthodontic clinical findings were followed during at least 17 years. Clinical results indicate a survival and success rate of implants of 92.9%, demonstrating that acid-etched surface achieves and maintains successful osseointegration. Five implants in three patients were lost during the healing period. Sixty-five prostheses were placed in 45 patients over the remaining 164 implants, 30 single crowns, 21 partially fixed bridges, 9 overdentures, and 5 full-arch fixed rehabilitations. A total of 12 implants were lost during the follow-up period. Mean marginal bone loss was 1.91 ± 1.24 mm, ranging from 1.1 to 3.6 mm. The most frequent complication was prosthetic technical complications (14.2%), followed by peri-implantitis (10.6%). The mean follow-up was of 214.4 months (208–228 months). Prosthodontic rehabilitation with an early-loading protocol over acid-etched surface implants is a successful implant treatment.